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Organization

WEST SIDE LLC

Active
Other names
Klondike Dental Care
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN PIPERIS JAMES DDS (PRESIDENT)
(765) 463-6726
Entity
Organization

Contact information

Practice address
3412 KLONDIKE RD, WEST LAFAYETTE BRA, IN 47906-5218
(765) 463-6726
Mailing address
3412 KLONDIKE RD, WEST LAFAYETTE BRA, IN 47906-5218
(765) 463-6726

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009311
IN

Other

Enumeration date
08/31/2006
Last updated
08/22/2020
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